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ArticleStroke and vascular neurology2026

Rationale and design of Low-Frequency REpetitive TRanscranial Magnetic Stimulation Combined with Endovascular Treatment in ACute Ischaemic StrokE (RETRACE II): a randomised double-blind controlled multicentre phase II pilot study.

Lingling Ding, Wenjie Wang, Tingyu Yi, Gaocai Zhang, Xinsheng Han, Wenhuo Chen, Hao Wang, Yongjun Wang, Zixiao Li

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in Stroke and vascular neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06064747 (Low-Frequency REpetitive TRanscranial Magnetic Stimulation Combined With Endovascular Treatment in ACute Ischemic StrokE), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06064747 nacompletednot on this map

Low-Frequency REpetitive TRanscranial Magnetic Stimulation Combined With Endovascular Treatment in ACute Ischemic StrokE (RETRACE-II): A Randomized, Double-Blind, Sham-Controlled, Phase 2 Pilot Trial

TypeinterventionalSponsorBeijing Tiantan HospitalRan2024 to 2025Enrolled60ConditionsStroke, Acute IschemicArmsLF-rTMS, Sham stimulation
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Lingling Ding *Department of Neurology, Beijing Tiantan Hospital, Beijing, China.ORCID http://orcid.org/0000-0003-0114-8157
Wenjie Wang *Department of Neurology, Beijing Tiantan Hospital, Beijing, China.ORCID http://orcid.org/0000-0003-2531-7285
Tingyu YiDepartment of Neurointervention, Zhangzhou Affiliated Hospital of Fujian Medical University, Fujian, China.ORCID http://orcid.org/0000-0003-3110-5844
Gaocai ZhangDepartment of Neurology, Kaifeng Central Hospital, Kaifeng, Henan, China.
Xinsheng HanDepartment of Neurology, Kaifeng Central Hospital, Kaifeng, Henan, China.
Wenhuo ChenDepartment of Cerebrovascular Disease, Fujian Medical University Union Hospital, Fujian, China.
Hao WangDepartment of Neurology, Linyi People's Hospital, Affiliated Hospital of Shandong Second Medical University, Linyi, Shandong, China.
Yongjun WangDepartment of Neurology, Beijing Tiantan Hospital, Beijing, China.ORCID http://orcid.org/0000-0002-9976-2341
Zixiao LiDepartment of Neurology, Beijing Tiantan Hospital, Beijing, China lizixiao2008@hotmail.com.ORCID http://orcid.org/0000-0002-4713-5418

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile endovascular therapy (EVT) remains the primary treatment for acute ischaemic stroke (AIS) management, persistent functional deficits in patients with successful recanalisation underscore the necessity for complementary neuroprotective strategies.

aimTo investigate the safety and efficacy of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) as a potential adjunctive neuroprotective intervention following EVT in AIS patients.

designThe Low-Frequency REpetitive TRanscranial Magnetic Stimulation Combined with Endovascular Treatment in ACute Ischaemic StrokE (RETRACE-II) trial is a phase II, multicentre, prospective, randomised, double-blind, sham-controlled pilot study. 60 successfully recanalised AIS patients with anterior circulation occlusion were equally randomised (1:1) to active LF-rTMS or sham intervention. The intervention involved administration of 1200-pulse 1-Hz LF-rTMS sessions (two times per day for 3 consecutive days) targeting the ipsilesional primary motor cortex (M1), initiated within 24 hours of symptom onset. Sham procedures maintained equivalent positioning with deactivated magnetic output. Standardised protocol assessments were conducted at 3-day (postintervention), 7-day and 90-day follow-ups. STUDY OUTCOMES: The primary efficacy endpoint was the proportion of early neurological recovery (defined as a reduction of ≥4 points on the National Institutes of Health Stroke Scale (NIHSS) or achieving a score of 0-1) at 3 days. Secondary outcomes included ischaemic penumbral salvage volume ratio, final infarct volume measured by brain MRI at 7 days, and modified Rankin Scale score at 90 days. Safety outcomes encompassed symptomatic intracranial haemorrhage, neurological deterioration (≥4-point increase in NIHSS score) and all-cause mortality through 90-day follow-up. DISCUSSION: RETRACE-II establishes methodological rigour for evaluating neuromodulation therapies during the hyperacute stroke phase, with findings expected to inform future trials and advance combination therapy paradigms in cerebrovascular neuroprotection. TRIAL REGISTRATION NUMBER: NCT06064747.

Indexed as

Endovascular ProceduresIschemic StrokeTranscranial Magnetic StimulationAgedAged, 80 and overClinical Trials, Phase II as TopicCombined Modality TherapyDisability EvaluationDouble-Blind MethodFemaleFunctional StatusHumansMaleMiddle AgedMulticenter Studies as TopicPilot ProjectsCerebral InfarctionStrokeTranscranial Magnetic Stimulation

Identifiers

PMID40721316
PMCPMC13347868

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.